DANIEL M RIESENBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

DANIEL M

Last Name

RIESENBERG

Suffix

Business Name

DANIEL M RIESENBERG MD

Original Issue Date

12/28/1994

Effective Date

12/28/1994

Expiration Date

07/31/1999

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006